Doctors' questions as displays of understanding

Based on German data from history-taking in doctor-patient interaction, the paper shows that the three basic syntactic types of questions (questions fronted by a question-word (w-questions), verb-first (V1) questions, and declarative questions) provide different opportunities for displaying understanding in medical interaction. Each syntactic question-format is predominantly used in a different stage of topical sequences in history taking: w-questions presuppose less knowledge and are thus used to open up topical sequences; declarative questions are used to check already achieved understandings and to close topical sequences. Still, the expected scope of answers to yes/no-questions and to declarative questions is less restricted than previously thought. The paper focuses in detail on the doctors' use of formulations as declarative questions, which are designed to make patients elaborate on already established topics, giving more details or accounting for a confirmation. Formulations often involve a shift to psychological aspects of the illness. Although patients confirm doctors' empathetic formulations, they, however, regularly do not align with this shift, returning to the description of symptoms and to biomedical accounts instead. The study shows how displays of understanding are responded to not only in terms of correctness, but also (and more importantly) in terms of their relevance for further action.